Provider Demographics
NPI:1497187447
Name:SEAGER, CYNTHIA G (ADC)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:G
Last Name:SEAGER
Suffix:
Gender:F
Credentials:ADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:199 STRATTON RD
Mailing Address - Street 2:
Mailing Address - City:RUTLAND
Mailing Address - State:VT
Mailing Address - Zip Code:05701-4890
Mailing Address - Country:US
Mailing Address - Phone:802-775-7798
Mailing Address - Fax:802-775-7762
Practice Address - Street 1:199 STRATTON RD
Practice Address - Street 2:
Practice Address - City:RUTLAND
Practice Address - State:VT
Practice Address - Zip Code:05701-4890
Practice Address - Country:US
Practice Address - Phone:802-775-7798
Practice Address - Fax:802-775-7762
Is Sole Proprietor?:No
Enumeration Date:2013-08-01
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT104148101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1018281Medicaid